Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment Reduces Variability in Brain Function in Schizophrenia: Data From a Double-Blind, Randomized, Sham-Controlled Trial.

IF 5.3 1区医学 Q1 PSYCHIATRY

Schizophrenia Bulletin Pub Date : 2024-10-07 DOI:10.1093/schbul/sbae166

Christin Schifani, Colin Hawco, Zafiris J Daskalakis, Tarek K Rajji, Benoit H Mulsant, Vinh Tan, Erin W Dickie, Iska Moxon-Emre, Daniel M Blumberger, Aristotle N Voineskos

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引用次数: 0

Abstract

Background/hypothesis: There is increasing awareness of interindividual variability in brain function, with potentially major implications for repetitive transcranial magnetic stimulation (rTMS) efficacy. We perform a secondary analysis using data from a double-blind randomized controlled 4-week trial of 20 Hz active versus sham rTMS to dorsolateral prefrontal cortex (DLPFC) during a working memory task in participants with schizophrenia. We hypothesized that rTMS would change local functional activity and variability in the active group compared with sham.

Study design: 83 participants were randomized in the original trial, and offered neuroimaging pre- and post-treatment. Of those who successfully completed both scans (n = 57), rigorous quality control left n = 42 (active/sham: n = 19/23), who were included in this analysis. Working memory-evoked activity during an N-Back (3-Back vs 1-Back) task was contrasted. Changes in local brain activity were examined from an 8 mm ROI around the rTMS coordinates. Individual variability was examined as the mean correlational distance (MCD) in brain activity pattern from each participant to others within the same group.

Results: We observed an increase in task-evoked left DLPFC activity in the active group compared with sham (F1,36 = 5.83, False Discovery Rate (FDR))-corrected P = .04). Although whole-brain activation patterns were similar in both groups, active rTMS reduced the MCD in activation pattern compared with sham (F1,36 = 32.57, P < .0001). Reduction in MCD was associated with improvements in attention performance (F1,16 = 14.82, P = .0014, uncorrected).

Conclusions: Active rTMS to DLPFC reduces individual variability of brain function in people with schizophrenia. Given that individual variability is typically higher in schizophrenia patients compared with controls, such reduction may "normalize" brain function during higher-order cognitive processing.

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重复经颅磁刺激（rTMS）治疗可降低精神分裂症患者大脑功能的变异性：一项双盲、随机、假对照试验的数据。

背景/假设：人们越来越意识到大脑功能的个体差异，这可能对重复经颅磁刺激（rTMS）的疗效产生重大影响。我们利用一项为期 4 周的双盲随机对照试验的数据进行了二次分析，该试验在精神分裂症患者的工作记忆任务中对背外侧前额叶皮层（DLPFC）进行了 20 赫兹的主动经颅磁刺激与假经颅磁刺激。我们假设经颅磁刺激将改变主动组和假主动组的局部功能活动和变异性。研究设计：83 名参与者在原始试验中被随机分配，并在治疗前和治疗后接受神经影像学检查。在成功完成两次扫描的参与者（n = 57）中，经过严格的质量控制，留下了 n = 42 人（主动组/假组：n = 19/23），这些人被纳入本次分析。N-Back（3-Back 与 1-Back）任务期间的工作记忆诱发活动进行了对比。在经颅磁刺激坐标周围 8 毫米的 ROI 中检查局部大脑活动的变化。个体变异性通过每位参与者与同组其他参与者大脑活动模式的平均相关距离（MCD）进行检验：结果：我们观察到，与假活动相比，活动组的任务诱发左侧 DLPFC 活动有所增加（F1,36 = 5.83，假发现率 (FDR) 校正后 P = .04）。虽然两组的全脑激活模式相似，但与假激活相比，主动经颅磁刺激减少了激活模式中的 MCD（F1,36 = 32.57，P 结论：主动经颅磁刺激对 DLPFC 的激活模式与假激活相似，但主动经颅磁刺激对 DLPFC 的激活模式与假激活不同：主动经颅磁刺激 DLPFC 可降低精神分裂症患者大脑功能的个体差异性。鉴于精神分裂症患者的个体变异性通常高于对照组，这种变异性的降低可能会使高阶认知处理过程中的大脑功能 "正常化"。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Schizophrenia Bulletin 医学-精神病学

CiteScore

11.40

自引率

6.10%

发文量

163

审稿时长

4-8 weeks

期刊介绍： Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.